Benefits Configuration Analyst

Job description:

Job Description

Role & Responsibilities

• Design, analyze, and implement benefit coding change requests with a high level of precision, ensuring alignment with client specifications and regulatory requirements.
• Gather, interpret, and evaluate complex client requirements to assess the impact of benefit designs on claims processing; effectively communicate tailored benefit setup options to stakeholders and internal teams, thereby advising on optimal solutions.
• Manage non-standardized plan design concepts and client programs by overseeing coding, rigorous testing, and validation processes to ensure accuracy and compliance.
• Lead collaborative dialogues within cross-functional teams to clarify client intent and optimize program setups, fostering alignment across project deliverables.
• Serve as a key troubleshooter by coordinating resolution efforts among multiple internal and external teams; ensure timely implementation of solutions and maintain high client satisfaction.
• Partner with technical and operations teams to translate client-specific requirements into detailed technical design specifications and data flow models, supporting development and coding efforts.

 

Experience & Qualifications

• Demonstrated knowledge of claims processing methodology with compulsory experience in working within Facets platforms.
• Expertise in benefit configuration and group setup processes, enabling precise and compliant benefits administration.
• Previous exposure to Healthcare Business Process Outsourcing (BPO) environments, delivering operational efficiencies and client-focused solutions.
• A minimum of 3 years' professional experience in claims processing within Facets environments, showcasing strong problem-solving and technical skills.
• Educational background meeting at least a high school diploma or equivalent undergraduate coursework relevant to healthcare or information systems.

͏ Performance Delivery Metrics No Performance Parameter Measurement Criteria 1 Process Adherence Number of cases resolved daily; compliance with process and quality standards; achievement of Service Level Agreements (SLAs); client Pulse survey scores; and overall customer feedback. 2 Self-Management & Development Productivity and efficiency metrics; attendance and punctuality records; completion of required training hours and technical certifications.

Candidates will be evaluated based on these performance indicators to ensure high-quality service delivery, continuous professional growth, and alignment with Wipro LLC's commitment to client satisfaction and operational excellence.

Mandatory Skills: Claims_Processing .

 

Experience: 1-3 Years .

 

The expected compensation for this role ranges from $58,000 to $62,000 .

 

Final compensation will depend on various factors, including your geographical location, minimum wage obligations, skills, and relevant experience. Based on the position, the role is also eligible for Wipro's standard benefits including a full range of medical and dental benefits options, disability insurance, paid time off (inclusive of sick leave), other paid and unpaid leave options.

 

Applicants are advised that employment in some roles may be conditioned on successful completion of a post-offer drug screening, subject to applicable state law.

 

Wipro provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. Applications from veterans and people with disabilities are explicitly welcome.

 

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